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Home My WebLink AboutAC CHANGE OUT LIKE FOR LIKE KLIMA RESIDENCE.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: k� )3 )I -Ls Permit Number: rpI V Building Permit Application Planning and Development Services Building and Code Regulation Division Commerciah Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMITAPPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: Address: 0-CO S, OCe�v\�r• Sc�$ Property Tax ID #: wLi b .--s Lot No. Site Plan Name:Block No. q, Project Name: A i `I4'4, (2 S)AZ.r Le, 6C� DETAILED DESCRIPTION OF WORK: 19 New Electrical Meter Second Electr. `al'Meter (Affidavit required) CONSTRUCTION INFORMATION Additional work to be performed under this permit- check all that apply: Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: _ Sq. Ft. of First Floor: Cost of Construction: $ LA Vim, 0 Utilities: _ Sewer _Septic Building Height: OWNER/LESSEE ,; CONTRACTOR: Name: L 1 Name Address: To9 ASL,l :i �ko C;r Company: �Q/a E 4Ww'y�D �l (b �c ��f City: V �ec ea- Stater Zip Code: Lq a'a Fax: Phone No. aka —12-4 40 Address: f-TO ieA✓i�r r �(- City: T SL- State: 1� Zip Code: � `(�S, Fax: -�Ib I-1w) PhoneNo 13 E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail iV%+" 10,tp State or County License C_AcaSba-;�_z If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. If value of HAVC is $7,500 or more, a RECORDED Noce of Commencement is required. f• li r. i• .. J ti - aT .. .S 1 •S•f.=J. N • DESIGNER/ENGINEER: ble MORTGAGE COMPANY:` Not Applicable Name: �'� Name: Address: '' Address: City: State:, `� City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BANDING COMPANY: Not Applicable Name: Name: Address: z . Address: City: City: Zip: Phone: Zip: Phone: �r OWNER/ CONTRACTOR AFFIDVIT: Application' is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of`a permit. St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested perynit, I do hereby agree that I will, in all respects, perform the work in accordance with the approved plans, the Florida B�flding Codes and St. Lucie County Amendments. The following building permit applications are exemp't+from undergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARNING TO OWNER: Your failure to Record'.a Notice of Commencement may result in paying twice for improvements to your property. A Notice -of Commencement must be recorded in the public records of St. Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent fof4vrwer STATE OF FLORIDA COUNTY OF 54— l� e Sworn to (or affirmed) and subscribed before me of -,"'.'Physical Presence or Online Notarization this 1IL'day of O . 202L by Name of person making statement. Personally Known OR Produced Identificat h3n T e f Identification Produced_ Ii %'n� TSAnature of Not lla rIy Public- State of Florida) . Commission No."1"l�1 1161" 7 (Seal) V JESSICA GROVER ,;Notary Public -State of Florida •= Commission # HH 119064 My Commission Expires April 19, 2026 REVIEWS I FRONT I ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED SUPERVISOR I PLANS REVIEW I REVIEW VEGETATION I SEA TURTLE I MANGROVE REVIEW REVIEW REVIEW O COMPRESSOR OS ONPS U HEAD PS ❑VOLTS AMP; O ELECTRICAL CONNECTIONS ❑ CONTACTS TIGHT & CLEAN Cl OIL LEVEL & CONDITION O CONDENSOR COIL ❑ CLEAN COILS CHECK FIN COND. ❑ENT IF LVG °F ❑ REFRIGERANT Or22 ❑Mice O FAN AND MOTOR OVOLTS AMPS O ELECTRICAL CONNECTIONS ❑ CONTACTS TIGHT & CLEAN ❑ FAN PULLEYS (ADJUST BELT) ❑ CHECK LUS BEARINGS & MOTOR ❑ EVAPORATOR COIL ❑ CLEAN & OIL & CHECK FIN ❑ENT DB—°F LVG DB ❑ENT Wa—°F LVG WB—`F UCONDENSATEAREAS D esPEcrh aElw fRari PaN DwsPEcr.&DLEANDRAH. t AIR FiCPE2S GCLEnNED DRERACED FLTERSIZE ❑ HEATINGASSY. OSLRNFR 8IEATE%CINNGFR ❑ FUEL SUPPLY & PRESSURE O PLOTASSEMBV( ❑FlANEPAaSIMENi DPnawJT�REiaraRUE aFt,N&IsarstMfcFlaFea oeta^m:nssBdaLv ORVVA VE OSmPFEAT OOEFRGSTCYCLE ❑ ELECTRICAL COMPTS. a RSAYS OCCNTACTORS OOvfliLnaD aPREssswnaf ❑THERMOSTAT Sox CREPLACE ORELCCATE ❑ DUCT SYSTEM STATIC PRESSURE RETURIN — SUPPLY FILTER U18TFVTING_ IEMPWg VEM Manufacturer BM OR# -- OWARQ-_ . . T RY SERVICE INV®/C,; SERVICE9 2 C= CALL.# - — -' SCHEDULED DATE 11 COVERAGES PREVIOUS _ _ _ ___. _ _. _ . __ ._ ,;J _:iliL10Y. ... :4_ ,_:Uii.J raJ_RE 3A CALLS _ - _ --- ..._ -.. T: A.:`' ✓ SERVICE -- REQUEST u �} / O COMPLETE OPARTS ORDER ORIt NOT HOME _ 1 ; 1 <<Lu - .. VDO - - ORESCHEDULE ❑ OTHER •' ' a • • DESCRIPTION OF WORK r f Lk aI"Ass XV A. r: vi h 7�C A16 P._ �n K \� t= II� nn TECH / I TIME TIME C ._ /VL #1 /� i IN f OUT • TECH TIME TIME - #2 IN OUT PAYMENT I have received and agree It a terms and conditions of my contract, and I understand that this "service is a claim a ainst my contract i PART WARRANTY PART NEEDED PART NEEDED P.O.# y All pa4 as recorded are VrlAated as per manufacturer specifications. LABOR GUARANTY The labor charge as recorded here relative to the equipment serviced as noted, Is guaranteed for a period of 30 days. We do not, of course, guaranty other parts than those we Install. If repairs later become necessary due to other defective parts, they will be charged separately. No guaranty on any drain stoppages. BFS WILL NOT BE RESPONSIBLE FOR PROPERTY DAMAGE WHEN REMOVING TO PERFORM NECESSARY SERVICE WORK AND I ACCEPT PERFORMED SERVICE AND/OR CHARGES AS BEING SATISFACTORY All sales are final with no adjustments or refund. �l lJ Xass CUSTOMER SIGNATURE PARTS LABOR SERVICE CHARGE OTHER DISCOUNTS TAX www.brewardfactory.com 3FS-2 Rev.6/2020 Licenses: CACO56778, CAC056774,. CAC057400, CFC056867, ESOCO(i336, 0040504, 0046467, 280095, 279402, 289307, 0081113, 0081114, ECi sm